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P.vlre. SAN JOAQUIN COUNTY <br />EN' ONMENTAL HEALTH DEPARTP IT <br />1868 East Hazelton Avenue, Stockton, CA 9521,.,-6232 <br />"'q�.-• Telephone: (209) 468-3420 Fax: (209) 468-3877 Web: www.sjgov.org/ehd <br />SWIMMING POOL OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date: <br />Address: 1,1533 2z <br />C4: <br />zip Cod : <br />" <br />Owner/Operator: <br />Telephone: <br />Program Element: <br />Program Record: • j <br />Insp ction Type: <br />Flow Rate (gpm): <br />�0 <br />pH: <br />-7'- /0 <br />Ch ori (ppm): <br />3. rG <br />Cyanuric Acid (ppm): <br />36 <br />Temp: <br />Reinspection on or after: <br />Other: <br />RECIRCULATION EQUIPMENT <br />The marked violations represent Health & Safety <br />Code Violations and must be corrected as indicated: <br />❑ Filters <br />El PUMPS <br />r / <br />V <br />, 1t <br />V <br />A+ <br />a <br />r <br />K <br />E] Chlorinator <br />❑ Flowmeter <br />AAA- <br />❑ Gauges <br />❑ Skimmer & Gutters <br />❑ Back Flow Prevention <br />❑ Main Drain Cover <br />( /'Qp-AI,Q Q <br />y <br />L //fie <br />� w , <br />El Equalizer Line Cover <br />'CONSTRUCTIONd'/ <br />lov <br />El Pool Shell <br />❑ Fencing/Gates <br />Z <br />rV <br />❑ Decking & Coping <br />❑ Wade Pool - 2 Main Drains <br />SAFETY EQUIPMENT <br />L <br />❑ Rescue Pole <br />❑ Life Ring <br />.2• <br />❑ Safety Signs <br />❑ Lifeguard <br />❑ Pool/Deck Lighting <br />7J nr7,00 <br />A4 A <br />❑ Ladders/Hand Rails <br />❑ Depth Markers/Tiles <br />❑ First Aid Kits <br />❑ Emergency Shut-off Switch <br />/ <br />q� <br />v <br />RESTROOMS <br />❑ Showers <br />❑ Toilet & Dressing <br />❑ Ventilation <br />- WATER QUALITY <br />❑ Chlorine <br />❑ pH <br />❑ Cyanuric Acid <br />❑ Clarity <br />❑ Test Kits <br />MISCELLANEOUS <br />❑ Supervision & Control <br />❑ General Sanitation <br />❑ Algae <br />r <br />` <br />P <br />Influent: PJ <br />1 <br />Effluent: <br />y) /��� <br />ICI(YJfj� <br />4( <br />Timeln: IReceived <br />By: <br />tspe ted by: <br />g_ <br />Time Out: <br />EHD36-015-8-12 SWIMMING POOL OR - Page A of -11 <br />